Provider Demographics
NPI:1811461692
Name:DICARLO, ERICA ROSE (LLMSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ROSE
Last Name:DICARLO
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:DICARLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW
Mailing Address - Street 1:28000 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2468
Mailing Address - Country:US
Mailing Address - Phone:586-753-0405
Mailing Address - Fax:
Practice Address - Street 1:24055 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1511
Practice Address - Country:US
Practice Address - Phone:586-445-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851117100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker